A conference of organ donation officials from six countries in Europe have agreed a declaration urging an increase in transplant rates to those of Spain, which would mean the UK more than doubling its number of operations and taking thousands of people off waiting lists.

The meeting in Frankfurt of doctors, politicians, transplant agencies and charities found organ shortages throughout Europe and "striking differences" in donation rates among the six nations represented. Spain had the highest rate, at 33 donors per million people, France 20, Italy 18.1, Hungary 16.4, the UK 13, and Germany at 12.2.

The Spanish system includes a presumption of consent to organ donation when someone dies - rather than the UK opt-in system of cards and online registration - and its rate is supported by a poor road safety record as well as greater surveillance of emergency departments for possible donors.

Conference organiser Dr Martin Molzahn, chairman of Germany's transplant agency, said: "Even though the legal and organisational frameworks vary greatly between the member states of the European Union, transplant candidates all over Europe suffer because waiting times are much too long."

He said yesterday's conference had agreed that there should be improved cooperation through sharing information, joint study of best practice models, and initiatives for standards in quality assurance and recipient safety, as well as round the clock support for hospitals from transplant "procurement" agencies.

Though it suggested no time frame for change, the joint declaration stated: "We want to work together to improve the situation for organ donation, so that all options for organ donation can be maximised. It is our objective to establish a rate of organ donation in all European countries which is similar to the current rate in Spain."

The conference nations were cautious about live donation or use of animal organs, adding: "Organ donation from deceased donors remains the main source of organs for transplantation. There are many situations where donation from living donors is justified from a medical, legal and ethical standpoint, but the health risks for the donor must always be taken into consideration.

"Alternatives to organ donation, for example, xenotransplantation, are being developed but will not be a short or medium term option for the candidates on the waiting lists."

The declaration rules out entirely any incentives for donation, stating: "Organ donation should always be the result of a free decision, motivated by solidarity and altruism. Material incentives for organ donation destroy such motivation. We therefore oppose material incentives, as we oppose all forms of organ trade."

A Department of Health spokesperson said that the declaration did not contradict existing UK practice, which can include compensating live donors - mainly relatives giving one of their kidneys - for loss of earnings while recovering from the operation.

The government hopes to raise transplant rates significantly over the next 10 years, using greater publicity, the online register of donors, improving clinical practice and better administration of tissue stocks, as set out in its recent report, Saving Lives, Valuing Donors: a Transplant Framework for England.

While it is planning legislation over the removal and retention of organs, following recent hospital scandals, the government has opposed a 10-minute bill that would have switched the UK from an opt-in system to one of presumed consent.